Friday, May 2, 2008

30 Week Update

We have reached the big 3-0. This is a big mile stone. At this point, survivability of preemie babies is excellent. The next big mile stone is 34 weeks, at which point Emma will be nearly fully developed and her lungs will be ready to breathe air. We are paying attention to dates now because Krista starting having contractions this past Sunday night. These aren't the mild, irregular Braxton-Hicks type. These were real contractions that at one point were about 3 minutes apart. Now before anyone starts getting worried, let me jump forward and tell you that things are normal now. The contractions mostly stopped and she is only having a few a day. It is completely normal to have a few contractions per day during the third trimester. We had our last doctor's appointment in Gainesville yesterday and she said we are in the clear after our scare earlier in the week. Everything is normal, but we are still watching in case anything comes back. On the bright side of things, I now know I can get to the hospital FAST. Of course I already knew that, but having a reason to get there certainly helps.

So now to fill in the story. Sunday night we were at the home of our friends, Rob and Sarah, playing Mario Kart Wii (a very fun game, by the way). We left and everything was fine. Krista laid down that night to go to sleep and everything was as it should be. As we were trying to fall asleep, she noted that the baby was pushing and that her lower back was sore. She had never had a contraction so she didn't know how to interpret it at first (besides, Emma likes to push against Krista's stomach with her head or feet). Eventually, I went to sleep as she was trying to fall asleep as well. Over the course of the night, she would fall asleep only to be woken up by pressure from the baby. In the morning, I got up and was working around the house. When Krista got up she noted that she didn't sleep much and that she thought she might be having contractions. I watched Krista for a while and it seemed that the contractions were increasing in frequency and intensity. At this point we decided to call the doctor. After some discussion, we were sent to the hospital.

At the hospital Krista was put on some monitors in the Labor and Delivery room. Emma's heartbeat sounded good but Krista was definitely having contractions spaced 3-4 minutes apart and her blood pressure was raised. Thankfully, our OB doctor was working at the hospital that night and we got to see her. They gave Krista some Terbutaline to ease the contractions. They also gave Krista an exam and ran a test. The exam showed that Krista's cervix was closed, however it was 50% effaced. The test was for Fetal Fibronectin, a protein given off by the amniotic sac wall prior to delivery. We had to wait two hours for the result of the test so they monitored Krista during this time.

While waiting, Krista had to be given a second dose of the medicine to curb the contractions. Around the end of the third hour we got the result of the test. The result was negative (good). A negative result means you have about a 99% chance that you will NOT deliver within the next two weeks. Following this result and noting that Krista's cervix had not changed during the three hours in the hospital, we were sent home. We were given some conditions to watch for in case we needed to come back. Once home (~3:30 pm) Krista laid down to take a nap. She slept for about 3 hours before she got up again. Over the next few hours, Krista would have about 2 contractions an hour. In general, the magic number is 5. If you exceed 5 contractions an hour, you need to call a doctor. For several hours, everything was fine (though she was really tired). Beginning around 9 pm, we started noticing an increase in the number thanks to our contraction count on the white board. Within an hour, Krista went from 2 per hour to 8 per hour. After two hours at 8 per hour it was time to call the doctor again. And back to hospital again.

It is now almost midnight. The doctor examined Krista again and her cervix still had not changed (even after 12 hours of contracting since the last exam). We were then given a choice, take more Terbutaline to stop the contractions or take an Ambien (a sleeping pill) to sleep it off. After discussing it, we decided to go the Ambien route because Krista was tired and Terbutaline makes you jittery. The next morning, things were back to normal (more or less). Since the excitement Monday, Krista now has a few contractions a day. As I mentioned earlier, though, everything is fine and we are still in good shape. Emma is healthy and Krista is taking it easy. We are in the process of finding a doctor in Charlotte now. I have a call in to one office that will be getting back with us first thing Monday (I called at 4 on Friday). The good news is that within about 25 minutes (an easy drive in Charlotte) is the region's best NICU hospital so any early surprises or complications can be handled locally by a very good team of doctors. Our biggest hurdle is getting an appointment soon. I will update once we know a little more.